van Oudheusden L J B, Meynen G, van Balkom A J L M
Tijdschr Psychiatr. 2015;57(9):664-71.
The high prevalence of psychiatric comorbidity is usually considered to be a problematic artefact of the DSM. Clinicians appear to be reluctant to register comorbid diagnoses.
To provide insight into the concept of 'psychiatric comorbidity', so that the phenomenon can be dealt with more efficiently in clinical practice.
We studied the literature and performed a theoretical analysis.
The high prevalence of psychiatric comorbidity is closely linked to the structure of the DSM and is leading increasingly to practical and theoretical problems. These problems have stimulated the development of several valuable alternative models of psychopathology. In the context of these developments, however, the use of terms such as 'artificial' has led to a needless and unfruitful polarisation of the debate. The debate needs to focus primarily on the usefulness of various models for patient care and research.
Psychiatric comorbidity is an inevitable consequence of a categorical approach to psychopathology, which is basically legitimate. As long as the dsm in its current form constitutes an important part of our diagnostic 'arsenal', we advise clinicians to register comorbid classifications in as much detail as possible and at the same time to give close attention to the correct interpretation of the phenomenon.
精神疾病共病的高患病率通常被认为是《精神疾病诊断与统计手册》（DSM）存在问题的人为产物。临床医生似乎不愿记录共病诊断。
深入了解“精神疾病共病”的概念，以便在临床实践中更有效地处理这一现象。
我们研究了相关文献并进行了理论分析。
精神疾病共病的高患病率与DSM的结构密切相关，并日益导致实际和理论问题。这些问题推动了几种有价值的精神病理学替代模型的发展。然而，在这些发展背景下，诸如“人为的”等术语的使用导致了这场辩论不必要且无成效的两极分化。这场辩论应主要聚焦于各种模型对患者护理和研究的有用性。
精神疾病共病是对精神病理学采用分类方法的必然结果，这种方法本质上是合理的。只要现行形式的DSM构成我们诊断“武器库”的重要部分，我们建议临床医生尽可能详细地记录共病分类，同时密切关注对这一现象的正确解读。
